30 September 2020
Nearly one million women in the UK have missed potentially lifesaving NHS breast screening due to COVID-19, the leading UK breast cancer charity has warned on the eve of Breast Cancer Awareness Month.
Breast Cancer Now estimates that around 986,0001 women missed their mammograms due to breast screening programmes being paused in March 2020,2 in a bid to reduce the risk of COVID-19 spreading and to free up emergency resource for the NHS.
Worryingly, the charity anticipates that around 8,600 of the women caught up in this backlog could have been living with undetected breast cancer, with their diagnosis delayed due to the detrimental impact of COVID-19 on the NHS.3
While the breast screening programme is now starting up again, at different speeds across the country,4 availability of appointments has been significantly reduced due to measures to enable social distancing and to prevent COVID-19 spreading. Combined with this, the significant backlog of women waiting for screening, and more women starting to come forward with concerns about possible breast cancer symptoms, will place huge pressure on the imaging and diagnostic workforce which was already over-stretched prior to the pandemic.
Breast Cancer Now is deeply concerned by these delays to breast screening as early detection is critical to preventing women dying from breast cancer. As such, delays have caused some women huge anxiety, and the reality is that if breast cancer is diagnosed at a later stage it may be harder to treat.
This is why the charity is urgently calling on Governments and NHS bodies across the UK to set out how the anticipated influx in demand for imaging and diagnostics will be met. It is also calling on the UK Government to commit in its upcoming Comprehensive Spending Review to investing in the NHS cancer workforce to ensure breast cancer cases are diagnosed as early as possible.
Baroness Delyth Morgan, Chief Executive at Breast Cancer Now, said:
“That nearly one million women across the UK were caught up in the backlog waiting for breast screening is cause for grave concern as we know that around 8,600 of these women could have been living with undetected breast cancer. Mammograms are a key tool in the early detection of breast cancer, which is critical to stopping women dying from the disease.
“We understand that the breast screening programme was paused out of necessity due to the global COVID-19 pandemic, but we must now press play to ensure that all women can access breast screening, and we cannot afford for the programme to be paused again.
“Governments and NHS health bodies across the UK must set out how the influx in demand for imaging and diagnostics will be met. The UK Government must also seize the timely opportunity presented by the Comprehensive Spending Review, to urgently invest in recruiting and training NHS staff so that the workforce is equipped to give all women with breast cancer the best possible chance of early diagnosis.”
Mary Wilson, Consultant Breast Radiologist at the Nightingale Centre, Wythenshawe Hospital, and Lead for the National Breast Imaging Academy Project, said:
“Screening diagnoses around 19,000 breast cancers a year in England and there has already been a delay of over four months in the programme. To not only maintain pre-pandemic levels of activity, but also do a huge catch up with inadequate workforce levels is an enormous mountain to climb.
“Our most valuable asset is our staff – we simply have to invest in them. We desperately need more radiologists. You can’t make a radiologist quickly, so a long-term investment plan is essential. There’s no overnight fix. As a nation we must recognise and address the workforce issues and invest in the NHS which throughout the pandemic has done a fantastic job. But we now really do need ongoing support.”
These findings come from the charity’s new report published today, ‘Press Play: getting and keeping breast cancer services back on track’, which puts a spotlight on the profound impact COVID-19 has had on breast cancer to date. The report also outlines recommendations as to how Governments and NHS bodies across the UK can tackle this crisis, ensuring rapid progress is made in breast cancer diagnosis, treatment and care and that this momentum is maintained even if further peaks of COVID-19 place further pressure on health services.
While screening comes with some risks to be aware of, Breast Cancer Now encourages all women to attend their appointments when invited. The charity also urges women who notice any new or unusual changes in their breasts to get in touch with their GP urgently, and it is critical women continue to do so during the pandemic. While most breast changes won’t be cancer it is crucial to get them checked as the sooner breast cancer is diagnosed, the more likely treatment is to be successful.
Anyone concerned about COVID-19 and breast screening can call the charity’s free Helpline on 0808 800 6000.
For further information or to arrange an interview with a case study or a spokesperson, please contact Breast Cancer Now’s press office at firstname.lastname@example.org or on 07436 107 914.
Susan Daniels, 60, a Quality Manager from Glynneath, missed her routine breast screening due to the pause of the screening programme. Two months later she discovered a lump in her breast and after getting it checked was diagnosed with breast cancer in June, had surgery and will soon be starting radiotherapy treatment. She said:
“I have always attended my breast screening when invited and so when we moved to a new area I called up in March to arrange the appointment I was due. When I was advised that screening was on hold due to the pandemic and that I would receive an invitation at some point in the future, it was disappointing but I understood that COVID-19 was making everything difficult. At that time though, I was blissfully unaware that I might have breast cancer.
“I wasn’t always terribly good at checking my breasts, but at the beginning of May I discovered a lump and when it hadn’t disappeared after a few weeks I made an appointment to get it checked out. The anxiety that comes with a possible cancer diagnosis cannot be really understood until it becomes a personal experience.
“When I was given the news I had breast cancer it was devastating and surreal at the same time. I felt like my body had let me down and that the only way to cope was to get the cancer out and undergo treatment as a matter of urgency. May seems almost a lifetime ago and I know that I am one of the fortunate ones to have undergone diagnosis, surgery and soon to be radiotherapy treatment in this time. In my opinion, screening is vital for early detection, as is self-checking. I cannot even begin to know the distress experienced by anyone who is still awaiting an appointment.”
Mother-of-two, Karen King, 49, a Civil Servant from Southampton, was diagnosed with breast cancer in September 2019 after attending NHS breast screening as part of a trial looking at the risks and benefits of extending the age at which women are invited to screening from between 50 and 70 years old, to between the ages of 47 and 73. She finished treatment, including a lumpectomy and radiotherapy, in March, just ahead of the national lockdown. She said:
“My breast cancer was picked up by an early mammogram as part of a trial that I was participating in, I had no idea that anything was wrong. My diagnosis was a complete shock, I tried to be positive and brave, but I was very emotional. It has changed me as a person – I’m not as active as I used to be, it has affected my mental health and I worry about the cancer coming back.
“I thank my lucky stars every single day that my breast cancer was caught early. I honestly believe that screening, and my surgeon, saved my life by finding my breast cancer when it did as I had no symptoms. I feel screening is very important, I am so lucky we have this screening programme and that the consultants and radiographers are so thorough.
“I really do worry about the backlog for women waiting for routine mammograms caused by the pandemic. I understand why screening had to be cancelled but I do know that it will have caused a lot of worry for a lot of ladies who may still be waiting for it to be rescheduled and I also have no idea if my annual mammogram will be affected when it's due in December.”
Notes to Editors:
Breast cancer is the most common cancer in women in the UK. The NHS Breast Screening Programme is vital in helping to detect breast cancer at the earliest possible stage, preventing around 1,300 women dying from the disease each year across the UK. Each year more than 2 million women have breast cancer screening in the UK. Women registered with a GP are invited for a mammogram between the ages of 50 and 53 every three years until their 71st birthday.
Breast screening, Cancer Research UK, https://about-cancer.cancerresearchuk.org/about-cancer/breast-cancer/getting-diagnosed/screening/breast-screening
1. The backlog before the breast screening programme restart: England – 837,940; Scotland – 77,660; Wales – 47,905; Northern Ireland – 22,856. In total 986,361.
2.The breast screening programme was officially paused in Scotland, Wales and Northern Ireland, and effectively paused in England, from March.
3.Undetected breast cancers during the screening programme pause: England – 7,374; Scotland - 676; Wales - 450; Northern Ireland – 155. In total 8,655.
4.Breast screening is now restarting, with the services resuming in Scotland on 3 August, Northern Ireland on 20 July and Wales in late summer. Although breast screening services in England were not officially paused they were effectively paused, and we have assumed a pause of four and a half months. Some services may have paused for shorter, and some for longer, periods.
https://www.health-ni.gov.uk/news/temporary-pause-routine-screening-programmes; https://www.gov.scot/news/breast-cancer-screening-to-resume/; https://phw.nhs.wales/services-and-teams/screening/breast-screening/breast-screening-programme-announcement/